Plmt biliary drainage cath at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$5,997.60
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$9,996.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$364.49 with UPMC Health Plan vs $7,996.80 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $364.49 | ↓ -94% |
| United Healthcare Community Plan for Families | Unison Kids | $381.05 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $460.54 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $491.39 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $499.68 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $517.27 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $564.69 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,115.58 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $2,116.50 | ↓ -65% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,483.88 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,228.85 | ↓ -46% |
| United Healthcare | Compass Exchange | $3,298.68 | ↓ -45% |
| Highmark BCBS of PA | Managed Care | $3,326.52 | ↓ -45% |
| UPMC Health Plan | Managed Medicare | $3,373.62 | ↓ -44% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,437.21 | ↓ -43% |
| UPMC Health Plan | CHIP | $3,498.60 | ↓ -42% |
| Aetna | Neighborhood Network | $3,508.60 | ↓ -41% |
| United Healthcare | Unison Advantage Non Special Needs | $3,532.77 | ↓ -41% |
| Aetna of PA | Medicare | $3,532.77 | ↓ -41% |
| United Healthcare | Medicare | $3,600.06 | ↓ -40% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,633.37 | ↓ -39% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,633.70 | ↓ -39% |
| Cigna | Medicare | $3,633.70 | ↓ -39% |
| AmeriHealth Caritas | Medicare | $3,633.70 | ↓ -39% |
| Aetna | Medicare | $3,700.99 | ↓ -38% |
| United Healthcare | Unison Advantage Special Needs | $3,700.99 | ↓ -38% |
| Aetna | EBR FI | $3,798.48 | ↓ -37% |
| Aetna | Home Depot Employer Group | $3,818.47 | ↓ -36% |
| Cigna | NBR ASO/FI | $3,898.44 | ↓ -35% |
| Cigna | New Business ASO | $3,898.44 | ↓ -35% |
| Aetna | NBR ASO/FI | $3,898.44 | ↓ -35% |
| United Healthcare | All Business | $3,898.44 | ↓ -35% |
| Aetna | EBR ASO | $3,998.40 | ↓ -33% |
| Cigna | EBR | $3,998.40 | ↓ -33% |
| Cigna | Commercial | $3,998.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,324.33 | ↓ -28% |
| UPMC Health Plan | Commercial | $4,903.04 | ↓ -18% |
| InterGroup | PPO | $4,998.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $6,653.05 | ↑ +11% |
| Coventry/First Health | Commercial | $6,997.20 | ↑ +17% |
| Private Health Care Systems | PPO | $7,996.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Plmt biliary drainage cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,482.60 | $331.35 – $5,976.80 |
| UPMC Carlisle | Carlisle | $7,503.60 | $420.81 – $10,630.10 |
| UPMC Community Osteopathic | Harrisburg | $7,503.60 | $447.32 – $10,630.10 |
| UPMC Hamot | Erie | $5,472.00 | $364.49 – $4,893.48 |
| UPMC Hanover | Hanover | $7,503.60 | $420.81 – $5,394.10 |
| UPMC Lititz | Lititz | $7,503.60 | $420.81 – $5,423.23 |
| UPMC Magee | Pittsburgh | $4,039.80 | $364.49 – $3,633.70 |
| UPMC McKeesport | Mckeesport | $5,809.80 | $364.49 – $3,700.99 |